Wound Healing and Care
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Questions and Answers

What is one potential complication of blood transfusions related to naturally occurring antibodies?

  • Graft vs. host disease
  • Allergic reactions
  • Hemolytic reactions (correct)
  • Volume overload

    • Which type of blood donation allows patients to have relatives or friends contribute blood for their use?

  • Directed transfusions (correct)
  • Perioperative cell salvage
  • Massive blood transfusion
  • Allogenic transfusions

    • In emergency situations, how critical is ABO compatibility for blood transfusions?

  • ABO compatibility is preferred but not required (correct)
  • ABO compatibility is vital but can be overlooked
  • ABO compatibility is irrelevant in all cases
  • It is mandatory for all transfusions

    • What is a common allergic reaction caused by transfused immunoglobulins?

    <p>Hives</p> Signup and view all the answers

    What condition may arise in immunosuppressed recipients from the engraftment of donor blood cells?

    <p>Graft vs. host disease</p> Signup and view all the answers

    What can be used when there are deficiencies in individual coagulation factors?

    <p>Fresh frozen plasma</p> Signup and view all the answers

    In which type of procedure can perioperative cell salvage be utilized?

    <p>Certain operative procedures</p> Signup and view all the answers

    What is the recommended ratio of chest compressions to rescue breaths for two rescuers performing CPR on an adult?

    <p>15:2</p> Signup and view all the answers

    How much fibrinogen is mentioned to be in less than 15 ml of plasma for transfusion?

    <p>150 mg</p> Signup and view all the answers

    What is a characteristic that differentiates benign osseous tumors from malignant ones?

    <p>Benign tumors are typically well-circumscribed.</p> Signup and view all the answers

    When a rescuer first approaches an unresponsive victim, what is the first step they should take?

    <p>Shake or tap gently and ask 'Are You OK?'</p> Signup and view all the answers

    Which technique is used to stage osseous tumors?

    <p>Enneking Surgical Staging System</p> Signup and view all the answers

    How often should rescue breaths be given to an adult victim during CPR after the initial actions?

    <p>1 breath every 6-8 seconds</p> Signup and view all the answers

    What factor is known to interfere with wound healing?

    <p>Smoking</p> Signup and view all the answers

    Which step should be taken if the victim shows no breathing but has a pulse?

    <p>Begin rescue breathing</p> Signup and view all the answers

    Which of the following is a common complication of total parenteral nutrition?

    <p>Infection at the catheter site</p> Signup and view all the answers

    What technique should be used to open the airway of an adult victim?

    <p>Head tilt/chin lift</p> Signup and view all the answers

    What is the correct response if the victim is breathing but has no pulse?

    <p>Start chest compressions immediately</p> Signup and view all the answers

    What is the primary goal of surgical approaches to reduce wound dehiscence?

    <p>To stabilize wound edges</p> Signup and view all the answers

    What type of tumors is classified as tumors of cartilaginous origin?

    <p>Chondrosarcoma</p> Signup and view all the answers

    During CPR for infants, how should chest compressions be performed?

    <p>With two fingers on the sternum</p> Signup and view all the answers

    What is the appropriate compression rate for adult patients during CPR?

    <p>100 per minute</p> Signup and view all the answers

    What is considered a function of growth factors in wound repair?

    <p>Stimulate angiogenesis</p> Signup and view all the answers

    What imaging technique is primarily used to assess bone tumors?

    <p>Magnetic Resonance Imaging (MRI)</p> Signup and view all the answers

    What is the expected hematocrit increase from one unit of blood with complications?

    <p>3%</p> Signup and view all the answers

    What is the primary requirement for blood compatibility?

    <p>ABO compatibility</p> Signup and view all the answers

    What is the recommended hematocrit threshold for anesthesia preoperatively?

    <p>Hct &lt; 30%</p> Signup and view all the answers

    What is the risk of developing Rh antibodies after receiving Rh-positive blood?

    <p>3-4 months</p> Signup and view all the answers

    What is a critical guideline regarding the use of RBCs after removal from refrigeration?

    <p>Must be used within 4 hours</p> Signup and view all the answers

    Which of the following is considered a noninfectious reaction to blood transfusion?

    <p>Febrile reaction</p> Signup and view all the answers

    What is the significance of saving Rh-units for women of childbearing age?

    <p>They are a population at high risk for Rh immunization.</p> Signup and view all the answers

    What is the approximate risk of contracting AIDS from a blood transfusion?

    <p>1:20,000</p> Signup and view all the answers

    Which sedative is indicated for prevention and treatment of convulsions?

    <p>Diazepam (Valium®)</p> Signup and view all the answers

    What is a common characteristic of Midazolam (Versed®)?

    <p>Rapid onset and short duration</p> Signup and view all the answers

    Which sedative has antihistaminic, antiemetic, and bronchodilating properties?

    <p>Hydroxyzine (Vistaril®)</p> Signup and view all the answers

    Which medication is contraindicated in cardiac patients due to its increased risk of bleeding?

    <p>IV ketorolac (Toradol®)</p> Signup and view all the answers

    What is the main purpose of using Atropine in patients with bronchial asthma?

    <p>Decrease respiratory secretions</p> Signup and view all the answers

    Which agent should be given with caution in patients with atrial flutter and increased intracranial pressure?

    <p>Diazepam (Valium®)</p> Signup and view all the answers

    Which medication typically pairs a strong emetic with an antiemetic?

    <p>Diazepam (Valium®)</p> Signup and view all the answers

    What effect does Hydroxyzine (Vistaril®) primarily aim to achieve when used as premedication?

    <p>Sedation</p> Signup and view all the answers

    Study Notes

    Wound Healing

    • Repair of Skin
      • Wound healing proceeds through four phases: inflammation, proliferation, remodeling, and maturation
      • It is a complex process involving the interplay of cells, growth factors, and extracellular matrix components

    Factors That Interfere with Wound Healing

    • Factors that hinder wound healing: malnutrition, smoking, diabetes, infection, inadequate blood supply, foreign bodies, and mechanical stress

    Wound Dressings

    • Dressing type: is selected based on the type of wound and its stage of healing
    • Moist wound healing: is important for promoting epithelialization and granulation tissue formation

    Suture Materials and Needles

    • Suture material: is chosen based on the type and location of the wound, the amount of tensile strength needed, and the patient's risk of infection.
    • Sutures can be: absorbable or non-absorbable, natural or synthetic.
    • Needles: come in various shapes and sizes to suit different tissues and suture materials.

    Surgical Approaches to Reduce Wound Dehiscence

    • Surgical techniques to minimize wound dehiscence (bursting open): proper closure, wound tension control, and good nutrition.
    • Dehiscence: can happen after significant trauma, surgical interventions, or when there is excessive stress or strain on the wound.

    Tourniquets

    • Purpose: to temporarily stop blood flow to a limb during surgery.
      • Applied distally to the surgical site, typically above the elbow or knee.
    • Complications: can include nerve damage, compartment syndrome, and tissue necrosis if left in place for too long.

    Blood Products and Indications

    • Packed Red Blood Cells (PRBCs)

      • Indications: to increase the oxygen-carrying capacity of the blood in case of anemia or significant blood loss.
      • One unit of PRBCs can raise the hematocrit by approximately 3% or hemoglobin by 1 g.
      • Compatibility: ABO compatibility is required, but Rh compatibility is preferred, not mandatory.
      • Adverse reactions: can range from allergic responses to life-threatening hemolytic reactions.

    • Fresh Frozen Plasma (FFP)

      • Indications: to replace clotting factors in patients with bleeding disorders or those who have received massive transfusions.
      • Compatibility: ABO compatibility is essential, but Rh compatibility is not strictly required in emergency situations.
      • Adverse reactions: relatively infrequent, but can include allergic reactions and transfusion-associated circulatory overload.

    • Cryoprecipitate

      • Indications: a concentrated source of fibrinogen and clotting factors. Used to treat patients with fibrinogen deficiencies and von Willebrand disease.
      • Compatibility: ABO compatibility is preferred but not required in emergency situations.

    Replacement Therapy

    • Fluid Management

      • Involves carefully monitoring and replacing fluids lost through surgery, trauma, or other medical conditions.
      • Goal: to maintain adequate hydration and electrolyte balance.

    • Intravenous Fluids and Therapy

      • Types of fluids: crystalloids (normal saline, lactated Ringer's), colloids (albumin, hetastarch), and blood products.
      • Fluid selection: depends on the type and severity of fluid loss, the patient's underlying medical conditions, and other factors.

    Viral Diseases

    • Viral infections: can cause a wide range of illnesses, from the common cold to life-threatening diseases like HIV and hepatitis.
    • Treatment: often focuses on supportive care, symptom management, and antiviral medications.

    Rickettsial Diseases

    • Cause: bacteria transmitted by ticks and mites.
    • Symptoms: fever, headache, rash, and muscle aches.
    • Diagnosis: based on clinical presentation and laboratory tests.
    • Treatment: antibiotics (doxycycline or tetracycline).

    Protozoan and Metazoan Infections

    • Protozoa: single-celled organisms that can cause diseases like malaria, toxoplasmosis, and giardiasis.
    • Metazoa: multicellular organisms that can cause infections like tapeworm, roundworm, and pinworm.
    • Treatment: depends on the specific organism and the severity of the infection.

    Estimating Blood Loss

    • Several methods: are used, including visual estimation, measuring blood loss from drains, and calculating blood loss based on the amount of surgical fluid used
    • Accurate estimation: necessary for determining the need for blood transfusions and other interventions.

    Osseous Tumors

    • Overview

      • Benign vs. Malignant: refer to the tumor's growth rate, invasiveness, and potential to metastasize.
      • Benign tumors: grow slowly and usually don't spread to other parts of the body.
      • Malignant tumors: grow aggressively and can spread.

    • Statistics

      • Bone tumors are relatively uncommon, but some types can be aggressive and life-threatening.

    • Staging Techniques

      • Enneking Surgical Staging System (SSS), a widely-used system for classifying bone tumors.
      • Uses a numerical code to describe the tumor's size, location, and invasiveness.
      • Helps determine appropriate treatment and predict the likelihood of cure or recurrence.

    • Radiology of Bone Tumors

      • X-rays, CT scans, and MRI scans essential for diagnosis and staging of bone tumors. They can reveal specific characteristics of the tumor, including its size, shape, location, and its effect on the surrounding bone.

      Benign Osseous Tumors

    • Classification

      • Tumors of Cartilaginous Origin: include osteochondroma, enchondroma, and chondrosarcoma.
      • Tumors of Fibrous Origin: include fibrous dysplasia, non-ossifying fibroma, and desmoid tumors.
      • Tumors of Unknown Origin: include giant cell tumor, aneurysmal bone cyst, and solitary bone cyst.

      Cystic Lesions of Bone

    • Include: simple bone cysts, aneurysmal bone cysts, and giant cell tumors.

    • Treatment: often involves surgical curettage and bone grafting.

      Other Bone Tumors

    • Include: osteoma, osteoid osteoma, bone island, and chondroblastoma.

    • Management: varies depending on the type and location of the tumor.

      Malignant Tumors

    • Include: osteosarcoma, chondrosarcoma, Ewing sarcoma, and multiple myeloma.

    • Treatment: usually involves a combination of surgery, chemotherapy, and radiation therapy.

      Bone Tumors: Quick Reference Chart

    • Chart provides: summarized information about the different types of bone tumors.

    • Includes: location, clinical presentation, and treatment options.

    Septic Arthritis

    • Infection within a joint: causing pain, swelling, and inflammation
    • Causes: bacteria, viruses, or fungi.
    • Treatment: antibiotics and drainage of the joint fluid.

    Osteomyelitis

    • Infection of bone: causes pain, swelling, and redness.
    • Causes: bacteria, viruses, or fungi.
    • Treatment: antibiotics and surgery.

    Complications of Total Parenteral Nutrition

    • Total Parenteral Nutrition (TPN): providing nutrients intravenously. It is a complex and potentially dangerous intervention.
    • Complications: can include infection, electrolyte imbalances, and liver problems.

    Mycology

    • Mycology: study of fungi.
    • Fungal infections can cause a variety of diseases in humans and animals.
    • Common fungal infections: athletes foot, ringworm, and yeast infections.

    Necorizing Infections

    • Severe bacterial infections: can spread quickly and cause tissue damage and death.
    • Prompt diagnosis and treatment: essential for survival.

    Calculations

    • Various Calculations: used in surgical care including fluid balance, blood loss, and medication dosages. Good understanding of these calculations is important to ensure patient safety.

    Check Responsiveness

    • Initial Step in Emergency Care: ensure the individual is responsive and able to communicate, prior to starting CPR.
    • Unresponsive Individual: requires immediate actions like opening airway and checking for breathing and pulse.

    AHA ECC Adult Chain of Survival

    • Steps: immediate recognition of cardiac arrest, early CPR, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care.

    Current Protocol

    • For the most up-to-date protocol: refer to the website of the American Heart Association (www.heart.org).

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    Goldfarb Guide 2018 Podiatric Surgery Review PDF

    Description

    Explore the intricate process of wound healing, which involves phases such as inflammation, proliferation, remodeling, and maturation. Learn about the factors that can hinder this process and the various types of wound dressings and sutures used in care. This quiz is essential for anyone interested in healthcare and wound management.

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